Serum uric acid plays a protective role for bone loss in peri- and postmenopausal women: A longitudinal study

Abstract

Bone mineral density 23Bone loss 24 Uric acid 25 Body composition 26 Fat mass 27Objective: Oxidative stress has been linked to osteoporosis. Serum uric acid (UA), a strong endogenous anti-28 oxidant, has been associated with higher bone mineral density (BMD), lower bone turnover and lower prev-29 alence of fractures in a large cross-sectional study of men. Whether this relationship is present in women and 30 how UA relates to changes in BMD longitudinally has not been examined.31 Methods: A sample of 356 peri-and postmenopausal women, mean age 60.5 years was studied. Each individ-32 ual had baseline BMD and body composition measurements by dual energy x-ray absorptiometry (DXA) and 33 at least one repeat measure, on average 9.7 years later. Annual rate of change in BMD (A%ΔBMD) was calcu-34 lated. UA was measured at each DXA visit. Calciotropic hormones and bone turnover markers were measured 35 at the final visit only.36 Results: Cross-sectional data analyses revealed that women with higher UA levels had significantly higher 37 absolute BMD measures at all skeletal sites. These women also had higher measures of body weight and its 38 components such as lean mass (LM) and fat mass (FM). Results of multiple regression analyses showed a 39 positive association between UA and BMD that remained significant even after accounting for possible con-40 founders including LM and FM. Regression analyses of the longitudinal BMD data demonstrated significant 41 associations between serum UA levels and annual rates of change in BMD at all skeletal sites. After adjust-42 ment associations remained significant for lumbar spine, forearm and whole body BMD but not for hip BMD.43 Conclusion: Higher serum UA levels appear to be protective for bone loss in peri-and postmenopausal women 44 and this relationship is not affected by changes in body composition measures.45

Serum uric acid is associated with quantitative ultrasound parameters in men: data from the Camargo cohort

“…An association with incident osteoporotic fractures has also been recently reported in Korean men over 50 years old (8), and older men enrolled in the Osteoporotic Fractures in Men (MrOS) study (9). Similar results have been published in peri-and postmenopausal women (10)(11)(12). However, recent data from NHANES do not support a positive association between serum uric acid and BMD (13).…”

“…Furthermore, a relationship between ROS or low serum levels of antioxidants and male osteoporosis has been pointed out (6). Nevertheless, there are few reports analyzing the role of uric acid levels in patients with osteoporosis (7)(8)(9)(10)(11)(12)(13). Nabipour et al (7), found for the first time, that higher serum uric acid levels were related to higher bone mineral density (BMD), and lower prevalence of vertebral and nonvertebral fractures in older men.…”

Association between allopurinol use and hip fracture in older patients

“…Several studies found that higher serum urate (which is a major risk factor for gout) is associated with higher bone mineral density and a lower risk of fracture [10][11][12][13][14]; one recent study showed no relationship between serum urate and fracture rates in older people [21], another recent study found that higher urate was associated with higher fracture rates in men [22]. Gout, ascertained by any use of allopurinol in a large Danish registry, was associated with higher fracture rates in men but not women [23].…”

“…ADP) by xanthine oxidase, it may also indirectly modulate the impact of ADP on purinergic signalling systems. However, any relationship between allopurinol use and fracture is likely to be complex; recent observational data suggest that elevated circulating urate levels are associated with higher bone mineral density and lower fracture risk [10][11][12][13][14], possibly due to antioxidant effects of urate itself. Hence analyses of the effect of allopurinol on fracture risk need to try and separate the effect of gout (a consequence of hyperuricemia) from gout treatment (allopurinol).…”

Ürik Asidin Antioksidan ve Pro-Oksidan Özellikleri ile İlgili Kavram ve Tartışmalarının Derlemesi

“…Recently, another cross-sectional study done in female subjects also revealed that uric acid has protective role in bone mineral density. A very recent study done by Makovey J et al, revealed that women with higher UA levels had significantly higher absolute BMD measures at all skeletal sites 36 . Therefore, higher serum UA levels appear to be protective for bone loss in periand postmenopausal women and this relationship is not affected by changes in body composition measures 36 .…”